What’s More Dangerous: Marijuana or Alcohol? Full Transcript

Stephen J. DUBNER: Hey podcast listeners, don’t forget our new book Think Like a Freak will be published on May 12th. So if you think you need to set aside a little bit of time on that day for some light reading, maybe you want to go ahead and call in sick right now just to get it out of the way.

Stephen J. DUBNER: Let’s begin with a thought experiment. Imagine a fantasy world that’s exactly as the world is today – smartphones, cars, podcasts, Jimmy Fallon at 11:35pm. But two things are missing: alcohol and marijuana. They don’t exist yet. Now, it may be hard to imagine that our civilization has gotten to this advanced stage without alcohol and marijuana – but that’s a different thought experiment. That’s not what I want to talk about today. What I want to talk about is this fantasy world – the one we have today – without alcohol or marijuana, and then tomorrow, they are both discovered. What happens now? How are each of them used – and, perhaps more important, how are each of them regulated? If we were starting from scratch – with no cultural or legal baggage, with no preconceptions – how would we weigh the relative benefits and, especially, the costs of marijuana versus alcohol?

David NUTT: Alcohol, I’m not so sure about alcohol. I wonder if alcohol was discovered today, I think people would be very concerned about the toxicity. And I suspect alcohol would be banned within ten years if it became available today. If marijuana was discovered today I think people would probably accept it.

ANNOUNCER: From WNYC: This is FREAKONOMICS RADIO, the podcast that explores the hidden side of everything. Here’s your host, Stephen Dubner.

Steve LEVITT: Humankind loves alcohol.

DUBNER: Steve Levitt is my Freakonomics friend and co-author. He’s an economist at the University of Chicago.

LEVITT: We should just start by saying that. That it is amazing how widespread alcohol use is, how much utility people get out of it. And we’re going to focus on the negatives now, but I think you can’t forget that basic point.

DUBNER: Okay, we won’t forget that basic point. But first, let’s focus on the relative costs of alcohol and marijuana. Now, I don’t mean the price; I’m talking about costs to society, especially. If the world suddenly discovered both alcohol and marijuana tomorrow, how would we assess their effects, and how would we treat each of them?

LEVITT: I’ll give you the answer of what an economist would do, which is obviously very different than what a politician might do, but an economist would take the view that things that people do to themselves maybe we shouldn’t worry about very much. That all we need to worry about when it comes to alcohol and marijuana are the externalities. What negative effect of my consuming alcohol is there on the people around me on society. And the same for marijuana. And those are numbers you can imagine trying to quantify. And what an economist would say is, ‘well, let’s just build into the price of alcohol a tax that is appropriate to try to internalize that externality.’ And then to do the same thing with marijuana. I think what we maybe have less information about what the externalities are on marijuana, but my guess is that many people, probably, rightly, would think that the externalities of marijuana are smaller than the externalities of alcohol.

DUBNER: Now, the reason that we have less information about the negative externalities of marijuana is because in most places, marijuana is illegal. This does a few things. It makes it harder to collect reliable data. It dictates the nature of the market for marijuana; when you have an illicit market, and the profits that go along with it, you have the potential for criminal activity and violence, and other costs to society – like the police and the jails you need to devote to marijuana. According to F.B.I. data, roughly half of all drug arrests in the U.S. are for marijuana offenses: 42 percent for possession and 6 percent for sale or manufacturing. But as we all know, marijuana is becoming legal in more places – in Colorado and Washington State here in the U.S.; in 2001, Portugal decriminalized personal possession of many drugs, including marijuana. President Obama, quite famously, told David Remnick of The New Yorker that “I don’t think it [marijuana] is more dangerous than alcohol.” Alright, so let’s start there, with something we can measure pretty well: how dangerous is alcohol?

NUTT: It’s a significant factor in high blood pressure and heart damage; it’s the most damaging drug to the brain.

DUBNER: That’s David Nutt. He’s a psychiatrist at Imperial College London and former chairman of the U.K.’s Advisory Council on the Misuse of Drugs – emphasis on former chairman; we’ll get to that in a minute.

NUTT: It’s one of the most addictive substances, and it’s associated with a whole range of different cancers. So overall, alcohol is responsible for shortening the life expectancy, accelerating death in over 3 million people in the world today. It’s the leading cause of death in the world today after tobacco.

DUBNER: Nutt worked in government for 10 years, trying to assess the relative dangers of all different sorts of drugs.

NUTT: And all the time I was trying to get evidence to dominate decision making, which is what the law says it should do. And all the time I was meeting resistance. And eventually I got sacked…

DUBNER: And why did David Nutt get fired?

BBC BROADCAST: Now, the government’s chief adviser on drug policy has been sacked after insisting that alcohol and cigarettes are more dangerous than cannabis and ecstasy. The Home Secretary Alan Johnson said he no longer had confidence in the advice being given by Professor David Nutt, who had also criticized Ministers for reclassifying Cannabis as a more serious drug.

DUBNER: So you can see which side of the debate David Nutt would land on in our marijuana vs. alcohol thought experiment. And it isn’t just the personal downsides of alcohol consumption; it’s the externalities, the societal costs. Drunk driving, for instance. In the U.S., there are roughly 10,000 alcohol-related driving deaths a year, roughly a third of total traffic deaths. Drinking is heavily correlated with other antisocial behaviors.

LEVITT: The share of people who are arrested who are, who have been drinking is shockingly high.

DUBNER: That’s Steve Levitt again.

LEVITT: And even more telling, in some sense, is that the share of victims of crimes are incredibly likely to be drunk as well. I always wondered whether it was just that everybody’s drunk all the time, or really being drunk puts you in situations where you get arrested. But, if you watch “Cops,” and as you know I watch “Cops.” If you watch “Cops..”

LEVITT: If you watch “Cops” the TV show, the next time you watch “Cops” the TV show, just try to keep a tally of every person who comes around who’s engaged with the police, what share of them do you think have not been using either drugs or alcohol in the last few hours, and it is a really, really low number.

DUBNER: Right, although, as a selection tool goes, that’s not very precise because it could be that all the non-drunk people are too boring for TV.

LEVITT: It could be. And it’s hard to know. But the official data, it is shocking. The level of alcohol abuse among people who get arrested is just amazingly high.

DUBNER: Here’s a number to consider: roughly half of all homicide offenders in the U.S. were under the influence of alcohol at the time of the crime. When it comes to domestic violence, roughly two-thirds of the offenders had been drinking. So you could imagine that if society was starting from scratch without alcohol, in this fantasy world, we might all say no way. It’s just too dangerous. And what about marijuana?

LEVITT: I don’t think that there is any evidence that links use of marijuana to increased violence.

DUBNER: Note that Levitt said “use of marijuana.” Not selling drugs, which as we know can create violence. That said, there was a time when marijuana use was linked to violence:

ARCHIVAL AUDIO: Marijuana, the burning weed with its roots in Hell.

Jeffrey MIRON: That was the whole “Reefer Madness” story from, you know, from 50, 60 years ago, that marijuana use made you a homicidal maniac.

DUBNER: That is Jeffrey Miron. He teaches economics at Harvard and is the director of economic policy studies for the Cato Institute.

MIRON: I don’t think there is much credibility left of that perspective. So many people are concerned that marijuana is what is known as a gateway drug, that is once you use marijuana it makes you more likely to use other drugs. I don’t think there’s any evidence for it that I would regard as statistically credible. All that one can really document is that many people who use harder drugs did use marijuana before they used harder drugs. But a huge fraction of those who use marijuana never go on to use harder drugs. So the effect, if any, would appear to be quite small. And of course we can point out that almost everybody who goes on to use marijuana or alcohol say, started off on mother’s milk or McDonald’s French fries. So the prior use by itself we don’t think of as causal, it’s just that there does seem to be an evolution in the pattern for those people who end up going on to use harder drugs.

ARCHIVAL AUDIO: Debauchery, violence, murder, suicide…and the ultimate end of the marijuana addict.

DUBNER: Here’s David Nutt again, the former U.K. drug czar:

NUTT: When we look at the health dangers of marijuana, we see that there are remarkably little considering the wide use of the drug. So in the U.K. there’s almost no deaths attributable to marijuana. And people say well how can that be? When people are smoking it year, on year, on year, and the truth is people actually don’t smoke as much burning material when they smoke marijuana. Also the marijuana leaf burns at a lower temperature than the tobacco leaf so in fact you get less toxic substances into the lungs.

DUBNER: In a 2010 study called “Drug Harms in the UK: A Multicriteria Decision Analysis,” Nutt and a group of colleagues tried to calculate the “harm score” of 20 different drug, not only alcohol and marijuana but heroin, meth, cocaine, LSD, and so on. They factored in mortality rate, the cost of dependence, the loss of relationships, injuries, crime, and they also looked at the costs to society in terms of health care, police and prison, and lost productivity. What’d they find? What would you guess was deemed the most harmful drug overall of these 20 drugs?

NUTT: It turns out that alcohol was the most harmful drug overall, largely because of the massive harms to society, the huge economic cost, the huge health care cost, the huge policing cost of alcohol to society. And cannabis scored less than half of the overall harms of alcohol.

DUBNER: Now keep in mind a few caveats. In this kind of calculation, the societal costs of alcohol are huge in part because alcohol is so readily available. It’s legal, it’s cheap, and for the most part society smiles upon it – compared to most of the other drugs on the list, which are illegal, not necessarily so cheap, and generally frowned upon. So while alcohol might have the highest “harm score,” that may be due in large part to the simple fact of its prevalence.

DUBNER: Now that said, the evidence is pretty compelling, that alcohol is harmful. So, coming up on Freakonomics Radio: what do you do about it? If the world just discovered alcohol, would you immediately ban it? Well, we’ve tried that before.

LEVITT: If something is worth fighting for, people are willing to fight.

DUBNER: Or: how about a different kind of alcohol – great taste, less killing.

NUTT: You’d have this safe alcohol that you could drink and have fun. But you could also take an antidote that would block its effects. So you would sober up within half an hour if you took a pill.

DUBNER: Alright, so if alcohol and marijuana were both suddenly discovered, and we set out to weigh their relative dangers to society, you might conclude that alcohol at least is pretty dangerous. So you may think – hey, let’s just prohibit it. That’ll work, won’t it? Here’s the economist Jeffrey Miron again.

MIRON: So what I was interested in was whether prohibitions of substances like alcohol or drugs are effective in substantially reducing the use of the substance that’s prohibited. And the best sort of example that we have to look at is alcohol prohibition in the United States, which occurred between 1920 and 1933. The problem of course is there are no decent data on alcohol consumption during prohibition because the government that normally collects such data acted as though alcohol consumption wasn’t happening. Of course some of it was happening. The question was exactly how much.

DUBNER: Since Miron couldn’t get data that directly spoke to alcohol consumption, he looked for a proxy. It wasn’t a perfect proxy, perhaps, but a useful one: cirrhosis of the liver, which is caused by alcohol abuse.

MIRON: And what you find is that alcohol prohibition seems to have had some effect in reducing alcohol use, maybe 10, 20, 30 percent. But it didn’t have an incredibly dramatic effect when alcohol prohibition was repealed, alcohol use did go up relative to various other factors one controls for, but again a moderate amount, say 20, 25 percent. It’s not as though we went from almost no consumption to some huge, you know, explosion. There was a modest increase in use.

DUBNER: So not only did Prohibition not eliminate the use of alcohol – not by a long shot – but it had some rather grim unintended consequences.

[ARCHIVAL AUDIO]

LEVITT: Sure, I mean, prohibition was a time of amazing violence. The homicide rate in the U.S. in the late 1920’s was as high as it’s ever been, and, you know, two-to-three times higher than now. And the homicide rate fell dramatically after the end of prohibition…And…you know, it makes sense to me that in every setting, when you don’t have well-defined property rights and you don’t have legal structures around it, if something is worth fighting for, people are willing to fight. They’re willing to take tremendous risks and violence becomes the tool. Now my own belief is that, I think people will be surprised that within the U.S. I just don’t think that there is enough money in illegal marijuana to make people want to do a whole lot of killing. Now I understand that in Mexico and in other places there is probably a lot of violence around marijuana but my hunch is that you won’t see really any change at all in drug-related violence in the places where you legalize marijuana because I don’t think that’s why people have been killing each other in the first place. I think they have been killing themselves over cocaine and other drugs that are more profitable.

DUBNER: Levitt, you’ve got 4 kids, the oldest is what, 14?

LEVITT: Uh huh.

DUBNER: So, if you could control all four of your kids in the future and require that they could only consume one or the other, marijuana or alcohol, which would it be?

LEVITT: I think that I would have them consume alcohol and not marijuana. Because I think alcohol is just such an integral part of being an American. And I think that if you have sensible attitudes towards alcohol it can be a huge positive and doesn’t have to be a huge negative. And I would maybe give you a different answer…

DUBNER: If you lived in Holland?

LEVITT: Or in Holland, but especially in thirty years. In thirty years I’d probably give you a different answer because the role of marijuana in society might change, the role of alcohol might change. And it may be that if the social role of marijuana becomes very prominent and the hanging out with the wrong kind of people destructive role goes away; that the pure consumption of the marijuana might be better. But the consumption of the alcohol and the consumption of the marijuana are such a small part of what the social meaning of it is that I think it would be crazy to try to raise a bunch of kids who I didn’t ever want to touch alcohol and who I encouraged actively to be marijuana smokers.

DUBNER: Okay, so go then beyond then your family and society at large, does then the social benefit of alcohol outweigh or justify the social costs of alcohol, which strike me as being incredibly high. I mean no one is looking for a ban here, but as a way of thinking about how we regulate and allow different kinds of activities… I mean I think all of this gets caught up in moral posturing by everybody because alcohol and marijuana both seem to stand for a lot, but if we were talking about just different activities that weren’t a controlled substance, I think people would have a different view, because marijuana to some people seems pretty benign and alcohol to those same people seems potentially to have a lot of costs spread across society.

LEVITT: I’ve never done a calculation, but my hunch is that the benefits of alcohol are huge relative to the costs of alcohol. If you’re willing to count the utility that people get from using and abusing alcohol as part of your calculus. I think it’s not even close. I think that the joy and the pleasure that people get from alcohol, as evidenced by the amount that we drink and how central it is to everything we do, is just orders of magnitude bigger than the costs. I think marijuana that’s probably true too, we just don’t have as much information. But I doubt ever we’re going to get to a place where if we had a vote and we said you could only have one, alcohol or marijuana, that marijuana would ever win. Because I think alcohol, somehow for whatever reason of how we’ve evolved, the brain loves alcohol in a way that I’m not sure the brain loves marijuana.

DUBNER: Well, we may find out just how much the brain loves marijuana, as it’s decriminalized in more places. We asked Jeffrey Miron what might happen as marijuana becomes more available – and if, say, some people substituted marijuana for alcohol.

MIRON: So several studies have looked at the following combinations of effects. If marijuana becomes legal and therefore more accessible and cheaper, and some people at least substitute from alcohol to marijuana, and if, as appears to be true, the negative effects on driving ability from marijuana are smaller, in no way zero, but certainly smaller, than those from alcohol then we should actually see fewer traffic fatalities, because some of the people who are driving under the influence would be driving under the influence of marijuana which seems to be less bad, and therefore we might see fatalities go down. And indeed, three or four studies over the past 20 years have found exactly that result. So there is this potentially beneficial externality from legalizing marijuana in inducing this substitution, which reduces traffic accidents.

DUBNER: But as Steve Levitt notes: we know that people love alcohol, side effects and all. So wouldn’t it be great if somehow we could have all the benefits without the costs? Remember David Nutt, the British psychiatrist who was fired for claiming that alcohol is more dangerous than marijuana? He has some ideas about that.

NUTT: Most of my professional career, I have been trying to find ways of treating alcoholism and helping people deal with the problems of alcohol dependence and alcohol withdrawal, and trying to find an antidote to alcohol. And I realize now that’s impossible. And it occurred to me a while back that maybe we’re asking the wrong question, rather than try to solve the problem of alcohol, why don’t we find an alternative to alcohol which doesn’t cause problems, find a safe alternative, a drug which makes you pleasantly intoxicated, but which does not cause addiction, does not rot your brain, you liver or your guts, etc. And when you think about that, the way to do that is to find a substance where you had an antidote, so when you got to a party have fun and then take the antidote and drive home safely. And you could imagine that if that were available and everyone used it you would save 3 million deaths a year, which is more than malaria, tuberculosis, and meningitis put together. Wouldn’t that be a good thing? And that’s what I’m trying to do. I’m trying to bring a rational approach to dealing with the problems of alcohol by getting rid of it and replacing it with a safe alternative.

DUBNER: This is something that David Nutt is actually working on – a synthetic alcohol, designed to mimic the effects of alcohol on the brain while minimizing all the downsides — hangovers, liver damage, and loss of coordination. In conjunction with this, Nutt and his colleagues have also been working on an alcohol antidote, a “sober pill.”

NUTT: So the idea would be you would have this safe alcohol that you could drink and have fun. But you could also take an antidote that would block its effects. So you would sober up within half an hour if you took a pill. And that would mean that you were perfectly, absolutely normal and you could drive home quite safely.